Healthcare Provider Details

I. General information

NPI: 1801030119
Provider Name (Legal Business Name): HALIFAX INTERNAL MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2009
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1129 N MAIN ST STE H
SOUTH BOSTON VA
24592-2549
US

IV. Provider business mailing address

1129 N MAIN ST STE H
SOUTH BOSTON VA
24592-2549
US

V. Phone/Fax

Practice location:
  • Phone: 434-517-6180
  • Fax: 434-517-6179
Mailing address:
  • Phone: 434-517-6180
  • Fax: 434-517-6179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: BABITA B PATEL
Title or Position: PRESIDENT
Credential:
Phone: 434-517-6180